ABSTRACT
The relative inelasticity of scalp skin and the irregular convexity of the cranial vault necessitate careful planning in the design and mobilization of scalp flaps. Rotation flaps adapt particularly well to the curves of the cranial vault. An experimental model has enabled us to study the design and mobilization of expanded scalp rotation flaps and to obtain maximal efficiency from the tissue expansion process. The use of a round tissue expander situated immediately adjacent to a scalp defect is an excellent method for the creation of a rotation flap. To optimize the use of the expanded tissues, the flap should be designed so that its border passes along the periphery of these expanded tissues. In cases in which it is advisable to separate the expander from the defect, such as when the defect is highly contaminated, efficient use of the expanded tissues can still be obtained by placing the expander at the site of a rotation flap backcut. Furthermore, although this study focuses on rotation flaps only, this same model can be used to examine and compare different closure methods using other types of flaps as well.
Subject(s)
Scalp/surgery , Surgical Flaps/methods , Tissue Expansion/methods , Child, Preschool , Humans , MaleABSTRACT
Dermatofibrosarcoma protuberans is an unusual cutaneous neoplasm. Because of its high propensity for local recurrence, a wide and deep excision is recommended as the only satisfactory treatment. This tumour can raise difficult problems of reconstruction to plastic surgeons particularly when located in the face. The authors present a retrospective study of twenty cases of dermatofibrosarcoma protuberans of the head and neck treated at the Saint-Louis hospital over a period of twelve years.
Subject(s)
Dermatofibrosarcoma/surgery , Head and Neck Neoplasms/surgery , Skin Neoplasms/surgery , Adolescent , Adult , Aged , Dermatofibrosarcoma/pathology , Female , Follow-Up Studies , Head and Neck Neoplasms/pathology , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Retrospective Studies , Skin Neoplasms/pathology , Surgical FlapsABSTRACT
Autologous nipple graft is a classical technique in nipple reconstruction. The authors present two cases of deferred development of specific lesions in the grafted nipple, including one historical case of Paget's disease. After reviewing the current state of knowledge concerning Paget's disease of the nipple and in the light of these two cases, the authors discuss the histogenesis of this disease and the pathology of the grafted nipple in reconstructive surgery.
Subject(s)
Breast Neoplasms/etiology , Mammaplasty/adverse effects , Nipples/surgery , Paget's Disease, Mammary/etiology , Adult , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Female , Follow-Up Studies , Humans , Mammaplasty/methods , Neoplasm Transplantation , Paget's Disease, Mammary/pathology , Paget's Disease, Mammary/surgery , Postoperative ComplicationsABSTRACT
The ideal extent of colic excision in the curative treatment of left colic cancers has not yet been defined. The aim of this study is to compare the survival rates following left hemicolectomy and segmental colectomy. Over a period of 5 years from 1980 to 1985, 270 consecutive patients with cancer of the left colon without visceral metastases nor invasion of neighboring organs were included in the study. Survival at 5 years was the main criterion of assessment, with mortality and morbidity being the secondary criteria. 10 patients were excluded a posteriori. Out of the remaining 260 patients, 131 were operated with left hemicolectomy and 129 with segmental colectomy. Both groups were comparable as regards age; sex, risk factors (diabetes, renal failure), radiation therapy, antimitotics, procedure of anastomosis (hand or machine), protective colostomy, size of the tumor, and Dukes' stage. Only the length of the colon resected proximel to the tumor was greater in left hemicolectomy. 16% of the patients had a Dukes A adenocarcinoma. Postoperative mortality was higher after left hemicolectomy (6.1%) than after segmental colectomy (2.3%), but not significantly. Morbidity was similar. The survival rate at 5 years, including immediate deaths, was 64.8% after left hemicolectomy and 65.8% after segmental colectomy. Both survival charts could be strictly superimposed without significant differences. Left hemicolectomy therefore produced results that were comparable to those of segmental colectomy.
